What is a colonoscopy?
Colonoscopy is the minimally invasive endoscopic examination of the large colon and the distal part of the small bowel with a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis (e.g. ulceration, polyps) and grants the opportunity for biopsy of suspected lesions.
How to prepare for the colonoscopy
The actual procedure itself is not so bad- as patients tend to be heavily sedated. You will feel no pain nor will you even remember most of the procedure or even much of the time following it.
However, let's be honest, no one likes the preparation for a colonoscopy. The 24 hour clean out process beforehand can be less than pleasant. Here are some tips to make sure you properly prepare for the colonoscopy and minimize the distress of the preparation:
- A week before taking the test, verify with your doctor about which medications and vitamins you are allowed to take. Most doctors recommend against taking certain things such as iron or advil as they can increase the risk of bleeding (from the procedure).
- The day before the procedure, make sure to fast. This means drink clear liquids only. Do not eat any solid foods (clear jello is ok). If you do not follow this and end up eating solid foods, the cleaning out process is much more uncomfortable.
- Even if you are hungry, do not eat! Try to fill the belly with clear liquids, sparkling water and drinks help a lot to take away the hungry feeling. It also helps to stay busy or distracted with movies, reading, working (from home), etc.
- Set yourself up at home or a comfortable location before you start drinking the solution. It takes some people very little time to start having runny stools. You will need immediate access to the bathroom.
- Have the bathroom set up with matches, soft toilet paper, and perhaps even some reading to help make the time you spend on the toilet more entertaining. You may also want to purchase some Balional or other type of anal cleaner/softener. This will help to keep the skin around the anus from getting too irritated.
- Follow the directions carefully from your doctor. Take 2-4 prescribed laxatives at 12noon to 2pm the day before the procedure. Wait a few hours and then begin to drink the laxative/colon clearing solution. Follow these directions carefully, you do need to quickly drink an 8oz glass of the solution ever 10 minutes. The goal is to have clear stool. If you do not have this after drinking half the solution, continue drinking the other half. Note: many patients are fine drinking only half the solution.
- Be patient with your bodily functions. Expect to have a tremendous amount of gas (flatulence) as well as lots of diarrhea. This is normal and is part of the clearing out process. It is also normal to have abdominal cramping; however, if you start to vomit, contact your doctor.
- Think positive thoughts! Try not to worry about the upcoming procedure. If you find yourself getting occupied with it, practice mellow breathing exercises or even meditation. Remember, your body will be deprived of nutrients and fluids so you may be less patient and energetic than you normally would be. Treat yourself with compassion. This is really important.
- Have a good friend or someone close to you take you to the procedure (and take you home.) You want to be comfortable enough with them that you will be ok if you start to ramble on after the procedure. Often the doctor will give certain medications that will make patients talk without remembering what they say. So, prepare your friend/driver and enjoy.
- Allow yourself lots of time to sleep after the treatment. The sedatives can make you tired. Taking a nap will make you feel much better.
- Be prepared to eat a big healthy meal after the treatment or after you "come to". You will be hungry!
- Try to relax and enjoy. Think of it as an opportunity to take 2 days off from life, stress, doing and thinking.
Recent Changes in Prep
Some of the procedures for the prep for the colonoscopy have changed. One of the newer versions allows for total consumption of the fluid to be less. Half the fluid is consumed the day before (in the same way that it was done in the old one,) and then the other half is consumed the day of the procedure.
Starting 5 hours before the procedure, one would drink the prescribed ounces of fluid every 15 minutes until the total amount of fluid is gone. Some people find the new way is much better. However, if you have an early morning procedure, this can make for a very short nights sleep, as you may be getting up in the middle of the night to drink more fluid. Doctors tend to prefer this method as it leads to a cleaner gut and a much lower chance of having to re-do the procedure.
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